which percentage roughly of medical bills do insurance companies actually pay you think? and why this is the case? when, why such legislation was passed in the USA allowing this ?

why insurance companies (officialy reason) get reimbursed or payed beforehand for medical expenses and is this why the hospitals, doctors as well as drug companies negotiate such crazy high prices with insurance companies for medical practices as well as drugs?

please explain what you can and how this compares to Britain or Europe or Canada , Japan, China or Australia if you know?

One Response to “How much do insurance companies get from the government in the USA for paying medical bills?”

I don’t think you understand the role of insurance companies in US healthcare.

Basically, most US healthcare service providers are private individuals and companies. Most people purchase (privately or through employers) health insurance, with monthly premiums paid, and any covered costs reimbursed when needed. It is in the best interests of insurance providers to keep costs low, so they often negotiate lower rates with providers. They also restrict coverage when possible. There is a broad range of insurance options available. from very basic to gold plated plans that cover almost any conceivable need. The cost of these plans varies commensurately.

The US Government does not pay insurance companies, except as regards to insuring their own employees

For those who choose or are unable to obtain insurance, direct payments must be made to the providers. That explains why medical costs are the leading cause of US bankruptcies.

The US government has a small role to play. They do provide programs for the very lowest income people and seniors (Medicare, Medicaid), but it is the estimated 40 million caught in the middle who suffer the most.

I can only compare this to the UK, Canada, and Australia. In the UK, medical providers are not private, they work for the NHS, and the NHS hires the people, builds the facilities, etc. Entirely different than the US.

In Canada, the providers are private, but we have a single payer system, where all residents are covered by a government health plan, which covers the costs.

In Australia, it’s a little of both. They have national healthcare, but also have a side by side private system that people can pay to be a part of. Want to go to a government hospital? No charge, but you will have longer waits and basic care. Want to stay in a plush wood panelled room, with a wine list? You can pay for that option.

Results are what tell the story. The US system is 30-50% more expensive than any of the others. Canada, the UK, Australia have roughly similar outcomes, based on rates of illness, child mortality, life expectancy. The US tends to be substantially worse. Not catastrophically worse, but statistically noticeable. In some areas, such as cancer survival, the US creeps ahead, but overall, you are going to live longer and be more healthy in one of the other countries.